Am J Obstet Gynecol. Coronavirus disease 2019 (COVID-19) in pregnant women: A report based on 116 cases

[tetano]

Am J Obstet Gynecol. 2020 Apr 23. pii: S0002-9378(20)30462-2. doi: 10.1016/j.ajog.2020.04.014. [Epub ahead of print]
Coronavirus disease 2019 (COVID-19) in pregnant women: A report based on 116 cases.


Yan J¹, Guo J², Fan C³, Juan J¹, Yu X², Li J², Feng L⁴, Li C³, Chen H², Qiao Y², Lei D³, Wang C¹, Xiong G⁵, Xiao F⁶, He W⁷, Pang Q⁸, Hu X⁹, Wang S¹⁰, Chen D¹¹, Zhang Y¹², Poon LC¹³, Yang H¹⁴.

Author information




Abstract

BACKGROUND:

The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a global public health emergency. Data on the effect of COVID-19 in pregnancy are limited to small case series.
OBJECTIVES:

To evaluate the clinical characteristics and outcomes in pregnancy and the vertical transmission potential of SARS-CoV-2 infection.
STUDY DESIGH:

Clinical records were retrospectively reviewed for 116 pregnant women with COVID-19 pneumonia from 25 hospitals in China between January 20 and March 24, 2020. Evidence of vertical transmission was assessed by testing for SARS-CoV-2 in amniotic fluid, cord blood, and neonatal pharyngeal swab samples.
RESULTS:

The median gestational age on admission was 38⁺⁰ (IQR 36⁺⁰-39⁺¹) weeks. The most common symptoms were fever (50.9%, 59/116) and cough (28.4%, 33/116); 23.3% (27/116) patients presented without symptoms. Abnormal radiologic findings were found in 96.3% (104/108) of cases. There were eight cases (6.9%, 8/116) of severe pneumonia but no maternal deaths. One of eight patients (1/8) that presented in the first- and early-second-trimester had a missed spontaneous abortion. Twenty-one of 99 patients (21.2%, 21/99) that had delivered had preterm birth, including six with preterm premature ruptured of membranes. The rate of spontaneous preterm birth before 37 weeks was 6.1% (6/99). There was one case of severe neonatal asphyxia that resulted in neonatal death. Eighty-six of the 100 neonates that had testing for SARS-CoV-2 had negative results, of these ten neonates had paired amniotic fluid and cord blood samples that were tested negative for SARS-CoV-2.
CONCLUSIONS:

SARS-CoV-2 infection during pregnancy is not associated with an increased risk of spontaneous abortion and spontaneous preterm birth. There is no evidence of vertical transmission of SARS-CoV-2 infection when the infection manifests during the third-trimester of pregnancy.
Copyright ? 2020 Elsevier Inc. All rights reserved.



KEYWORDS:

Ascending infection; COVID-19; Coronavirus; PTB; SARS-CoV-2; coronavirus disease 2019; pandemic; pneumonia; pregnancy; pregnancy outcomes; pregnant women; preterm birth; severe acute respiratory syndrome coronavirus 2; spontaneous PTB; spontaneous abortion; spontaneous preterm birth; vertical transmission


PMID:32335053DOI:10.1016/j.ajog.2020.04.014